| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,258 |
1,093 |
$57K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,347 |
1,242 |
$36K |
| 92015 |
Determination of refractive state |
1,958 |
1,800 |
$31K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
602 |
597 |
$26K |
| V2020 |
Frames, purchases |
349 |
339 |
$13K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
175 |
147 |
$6K |
| V2025 |
Deluxe frame |
127 |
110 |
$5K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
375 |
363 |
$4K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
28 |
28 |
$1K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
101 |
101 |
$1K |